Diabetes and sleep: a complex cause-and-effect relationship.
adolescents, diabetes management, sleep quality, type 1 diabetes. Topic: Diabetes and sleep: A complex cause-and-effect relationship. improve sleep quality among people with type 2 diabetes. Shamshirgaran SM .. Unlike our study, a significant relationship between. HbA1C and PSQI has Regarding the negative effects of treatment with insulin on diabetic . Barone MT , MennaBarreto L. Diabetes and sleep: a complex cause andeffect. Background: Sleep is crucial for health, and people with diabetes are L () Diabetes and sleep: A complex cause-and-effect relationship.
Late adolescence is an especially important time to study the relation between diabetes management and sleep quality, as they both deteriorate during this time of development.
It is important to examine daily links between sleep quality and diabetes management given the daily regulatory challenge of managing diabetes and the demonstrated associations between sleep quality and diabetes management. The broader literature on sleep suggests that daily differences in sleep have implications for health during adolescence e. Less is known, however, about how variations in nightly sleep quality relate to health outcomes during adolescence.
Fuligni and Hardway suggested that assessing daily variability in sleep quality would provide a clearer picture as to why fluctuations in sleep influence some adolescents more than others. Daily variations in self-reported sleep quality may be especially informative in understanding daily diabetes management given the potential disruptions in crucial cognitive e. Poorer daily quality of sleep may put adolescents with type 1 diabetes at higher risk of experiencing self-regulatory failures related to diabetes e.
In support of the idea that sleep would be associated with more self-regulation failures, insufficient sleep quality has been associated with worsened daytime cognitive and emotional functioning in adolescents, which may contribute to poor adherence practices.
Moreover, poorer sleep quality also relates to increased food intake and unhealthy diets Chaput, Barber and Munz reported that inconsistent sleepers did not exhibit the benefits of good sleep. Thus, it may be the case that the regulatory benefits of daily sleep are not seen for self-regulation failures, BG checks, and BG regulation for those who report inconsistent sleep quality. In the present study, we conducted a secondary analysis of a larger, ongoing data set to examine the associations between daily sleep quality and aspects of daily diabetes management, including daily self-regulatory failures, frequency of BG checking, and risk of high BG.
We used a daily diary method to examine both between- and within-person differences in sleep quality related to these outcomes. We captured perceived sleep quality via three different facets: We first tested the main effects of each of these facets of perceived sleep quality on the diabetes management outcomes and then examined whether good daily sleep quality was most beneficial for those who had more consistent sleep quality across the 14 days.
Based on the existing literature, we hypothesized that both between- and within-person differences in sleep quality would be associated with diabetes outcomes. At the between-person level, individuals who had higher average sleep quality and who had higher consistent sleep quality across the 2-week diary were expected to display better diabetes outcomes i. At the within-person level, we hypothesized that higher daily sleep quality would be associated with fewer self-regulatory failures, more BG checks, and lower risk of high BG on days following a night of higher quality sleep.
Link Between Sleep & Diabetes: Everything You Need To Know
As described above, we additionally tested an interaction of between-person inconsistent and within-person daily deviations effects of sleep quality to examine whether the daily benefits of good-quality sleep are greater for those who consistently report getting good-quality sleep. Method Participants High school seniors with type 1 diabetes were recruited for a 2-year longitudinal study on diabetes management and self-regulation during late adolescence and emerging adulthood.
Participants were recruited from outpatient pediatric endocrinology clinics in two southwestern U. Consistent with the patient population at participating clinics, Parents had a range of educational backgrounds, with The present study analyzed baseline data from participants who responded to the daily diary. Of the individuals enrolled in the full study, completed the daily diary measures.
Adolescents in this subsample were Procedure The appropriate institutional review boards at each site approved the study, and all APA Codes of Conduct were followed. Adolescents completed a day online end-of-day diary measuring among other variables daily BG values, frequency of BG checking, and nightly sleep quality. Participants received the diary nightly via an e-mail link, and if it was not yet completed by 9: All baseline data were collected during the academic year September—June and data collection did not occur over holidays or school breaks.
Daily Self-Regulatory Failures Adolescents completed eight items each day that were developed to capture failures in self-regulation involving cognitive, emotional, and behavioral processes surrounding BG checking. They are usually worn in the mouth at night during sleep. When it comes to appearance, it looks very similar like a sports mouth guard.
They are fitted over the upper and lower dental arches, and may have metal hinges to ease the lower jaw forward. Tongue Retaining Device This device is a splint that keeps the tongue in place so that the airway maintains open for breathing. The tongue retaining device is most beneficial for individuals who sleep regularly on their backs or stomachs, and snore frequently. By wearing the tongue retaining device, individuals have found that the device greatly reduce the frequency and loudness of their snoring as well as jerking awake due to choking.
Patients who should NOT try it: Individuals who have central sleep apnea or are morbid obesity. These devices are also unsuitable for patients who wear dentures or have poor dentition because the teeth are essential to hold these devices in place.
Those individuals who suffer from apnea due to acute temporomandibular joint derangement or disc displacement are unsuitable for the device as well. In addition, those with steep mandibular planes or long necks also tend to have less success with these oral appliances.
You may already have seen them at the grocery stores or local pharmacies such as CVS, Walgreens, and Riteaids. If you have not seen one before, a nasal strip looks like a bandage in appearance.
They are beneficial for individuals who are born with narrow nostrils and have difficulty breathing because of the problem. These nasal strips are also effective for person who suffer from frequent nasal congestion, mild obstructive sleep apnea, or snoring due to nasal congestion, a deviated septum, or nostril collapse.
For severe cases of sleep apnea, although they may not be able to help with treating the apnea episodes, they may still be helpful for patients to minimize snoring. At the same time, it has been proven beneficial for patients who use the nasal strips in conjunction with their CPAP machines to maximize airway to the lungs. There are many brands of nasal strips available on the current market. According to statistics, Breathe Right Nasal Strips is the most reliable and most popular choice on Amazon.
Although they may be slightly more expensive than generic brands, many reviewers have praise Breathe Right for the comfortable adhesive ability being durable throughout the night yet gentle on the skin. If you are not an online shopper, you can also purchase them at most local pharmacies and grocery stores. Nose Cones Unlike the nasal strips that are applied to the outside of the nose, the nose cones are inserted in the nostrils to instantly maximize the nasal airway opening for easy breathing.
These are most beneficial for individuals who suffer from deviated septum as they can instantly correct the problem without needing surgery augmentation to fix the problem. If you are wondering if nose cones will help with your problem, simply try this Cottle Maneuver test: Use your thumb to block one of your nostril. Gentle dilate your other nostril by tugging it open sideways towards your cheek. Breath in normally through the dilated nostril.
Repeat the same procedure on your other nostril. If you feel that there is an instant improvement in the airflow and you can breathe easier from dilating your nostril, then nose cones will be beneficial with your current condition.
If you feel that there is no improvement to your breathing, then it is likely that your problem is too complex for both nasal strips and nose cones. In such circumstances, you may need to see a specialist about the physical obstruction problem that contributes to your sleeping disorders and sleep deprivation. Like nasal strips, there are many brands of nose cones on the market. Although they work in the same way, they are slightly different in designs and material use.
Of the choices available, Max-Air Nose Cones is the most popular choice as they are made with surgical rubber and comes in 3 different sizes for optimal fitting. They are available on their official website or you can call to order at Although it can keep your airway open during breathing, it is nowhere as powerful as a CPAP machine as the Airing device is powered by battery.
For individuals who suffer from mild to intermediate level of sleep apnea, the pressure created by the Airing nose device micro air blower may already be sufficient to keep them breathing comfortably in their sleep.
As this device is still in the production phase, you may want to keep an eye out for their release date. To find out more about the Airing Micro-CPAP nose device, you can visit their official crowdfunding website for further information. Breathing Aid Apparatuses When the cause of sleeping disorder is too severe for simple breathing aid devices such as nose cones and mouth guards, your doctor may suggest more intense breathing aid apparatuses to help you with your breathing difficulties: Using supplemental oxygen supply during sleep may help if you have central sleep apnea where you stop breathing.
Continuous positive airway pressure CPAP. This method is most commonly used for obstructive sleep apnea treatment. It involves the patient to wear a pressurized mask over their nose during sleep to keep the airway from collapsing so that the patient can breathe properly.
Aside from sleeping apnea, CPAP has proven to be beneficial for snoring as well. Bilevel positive airway pressure BiPAP. Essentially serves the same purpose as a CPAP machine. But unlike CPAP, which supplies a constant pressure to the upper airway as the patient inhales and exhales, the BiPAP builds to a higher pressure when you breathe in and decreases to a lower pressure when you breathe out.
This machine is more beneficial for patients who have problem exhaling against the incoming air. When the patient falls asleep, the machine sets the pressure to normalize their breathing pattern to avoid pauses in their breathing. ASV has proven to be most successful at treating complex sleep apnea in some people. Oxygen Concentrator An oxygen concentrator operates by filtering the air in the room to deliver oxygen.
Oxygen is delivered in two forms: In order to ensure an oxygen concentrator is operating at optimal function for your needs, you will undergo several tests under a lung specialist. These tests will help determine the current state of your lung function and if you need to use oxygen therapy. Oxygen concentrators are available in portable and home models. It operates by pushing a constant stream of air into the airways as opposed to concentrated oxygen like the oxygen concentrator. A sleep therapist will work with you to determine the dosage setting necessary for your CPAP machine.
Difference Between Airflow Machines and Oxygen Concentrator In a sense, oxygen concentrators and airflow devices serve the same purpose: However, the similarity ends here as the two types of devices work in completely different ways.
And although there are a few exceptions, the two types of devices are mainly used to treat completely different sleep disorders. Oxygen concentrators serves the main purpose of providing oxygen-enriched air for the patient to breathe.
Oxygen concentrators are for patients who need extra oxygen to compensate for a variation of heart and lung conditions such as emphysema and congestive heart failure.
They operate by running room air through containers of filters made of zeolite to omit nitrogen out of the air and leaving the air up to 45 percent richer in oxygen.
Airflow machines are air pressure devices for keeping the airway from collapsing so that the patient can breathe throughout sleep without suffocating and choking.
In fact, the first models of airflow machines were built based on vacuum. These airflow machines are only used to treat one thing — obstructive sleep apnea. Although the oxygen concentrators and airflow machines both deliver air to a facemask, the two masks are designed differently. In general, airflow machines deliver much higher pressure to the mask than do oxygen concentrators.
Even though both type of devices increase blood oxygen level, the airflow machines achieve this effect by permitting the patient to breathe more efficiently and not by supplying supplemental oxygen. Please note that in cases where the patients require supplemental oxygen constantly 24 hours a day, the doctor may prescribe a conjunction use of both the oxygen concentrators during daytime and airflow machine at night during sleep.
But for most sleep disorder cases, the doctor will prescribe only the airflow machines as breathing aids.
Keep your airway open while you sleep Correct snoring so others in your household can sleep Improve your quality of sleep Relieve sleep apnea symptoms, such as excessive daytime sleepiness Decrease or prevent high blood pressure Decrease your overall stress and anxiety level Many people who use airflow machines state that they immediately feel better overnight once they begin their treatment.
After their first night of sleep with the machine, they feel refreshed in the morning. In addition, they can concentrate better on their work and no longer feel a general sense of malaise throughout the day. As for children and infants who suffer from sleep disorder, airflow machines can greatly increase the survival rate of infants whose lungs have not fully developed. Disadvantages of Airflow Machines The principal disadvantage to airflow machines is that not everyone can adjust to to sleeping with the device overnight.
Depending on what position you usually sleep in, you may need to adjust to a new sleeping position to accommodate the facial mask. As a result, some people have difficulty sleeping the first few nights of the treatment.
Other disadvantages of CPAP machines include: Dry mouth from the constant air blowing Increase chances of nasal congestion, sinusitis, or nosebleeds Irritation and sores over the bridge of the nose from wearing the mask Stomach discomfort as a result of the constant air flow Chest muscles discomfort Feelings of confinement from the facial mask If you have any of these problems or any other problems with your CPAP machine, do not hesitate to call your doctor.
There may be ways to readjustment the machine to better fit your needs. For example, if you are constantly having dry mouth and dry nasal passages, there are some CPAP machines that are equipped with heated humidifiers to reduce your problem. For other problems, your doctor may prescribe a custom cushioned face mask and chin straps to relief the irritation on the bridge of your nose. If you have never sleep with something on your face, this will take some time for you to adjust to the mask without needing to fumble with it during your sleep.The 2 Most Ignored Minerals In Diabetes and Insulin Resistance
Depending on your needs, your mask may come in the form of: A nasal mask that covers your nose A padded nasal mask that fits under your nose A full mask that goes over both your mouth and nose A full-face masks that covers your whole face A nasal mask with prongs that protrudes into your nose For any reason the mask is irritating your skin or your face, let your doctor know.
There are options and accessories available to make the mask sits comfortably on your face. In order for you to receive the full benefits from the airflow machine, you must learn how to put on the mask correctly.
Usually, as long as you ensure that the mask is properly sealed and the air pressure from the tube remains constant, the machine will work its magic. If you find the prescribed pressure to be too much for you, let the doctor know and request to start with lesser pressure.
Diabetes and sleep: a complex cause-and-effect relationship. - Semantic Scholar
Once you get used to the machine, you can readjust the pressure to suit your needs. Surgical Procedures for Sleep Disorders If your sleep disorder has proven to be too severe and complex for all other options, your doctor may recommend certain surgical procedure as treatment.
It is a minimal invasive surgical procedure that utilizes radiofrequency currents to decrease tissue volume at a specific location that is causing the sleep disorder. Uvulopalatopharyngoplasty UPPP UPPP is the typical apnea surgery procedure of removing the soft tissue from the back of the throat to permit more airflow passing through the air passage in and out of the lungs. Inspire Upper Airway Stimulation UAS Implants A procedure in which a system is implanted in the patient to sense breathing patterns and delivers mild stimulation to keep the airway open during sleep.
This method may be beneficial for individuals who do not benefit from the airflow machine therapies. If obesity is the main cause of the sleep disorder as well as diabetes, procedures such as bariatric surgery, gastric banding, sleeve gastrectomy, and gastric bypass surgery may be recommended to achieve significant overall weight loss.
Liposuction and removal of fat tissue in the upper thorax and neck may also be suggested to remove the obstruction to the breathing pathway. These are the first line therapy for patients who have BMIs greater than 40 and are severely obese.
Which Treatment Should I Pick? The best treatment for sleep apnea depends on a number of factors: Severity of your problem Physical structure of your upper airway Other medical problems you have Your personal preference Your financial status and insurance coverage In general, your doctor will provide you with the most simple and least invasive treatment as your initial treatment.
However, your specialist may have much more experience treating patients with symptoms similar to your conditions and will have better recommendation as your treatment. Medication for Sleep Disorders Sleep disorders are often a byproduct of another underlying health problem.
As a result, doctors typically do not prescribe medicines to treat sleep disorders. However when patients suffer from chronic sleep deprivation, the doctors may prescribe supplements or sleeping tablets as an immediate short-term relief so that the patients can restore their normal sleep patterns.
These sleeping tablets are only prescribed as a short-term treatment because they are highly addictive and can lead to overdose if not properly used. At the same time, sleeping tablets have many side effects such as inhibiting the ability to drive and operate machinery.
These effects can persist til the next day and can cause serious side effects or overdose if combined with alcohol consumption. So before you start taking sleeping medications, ask your doctor about possible side effects. In case you wonder what possible medications are prescribed for treating sleep disorders, here is a list of medications that have been used to alleviate various symptoms that stems from sleep disorders. The list includes antidepressants, respiratory stimulants, central nervous system stimulants, and hormones.
Modafinil Modafinil is classified as a wakefulness-promoting agent. Itis often prescribed for patients who have responded moderately to airflow machines and are experiencing symptoms such as excessive daytime sleepiness, narcolepsy, and shift work sleep disorder. Patients should be aware that Modafinil is not a treatment for these sleep disorders; it only alleviate the symptoms.
Those who are treated with Modafinil may feel more focused during the daytime. Those who undergo Modafinil treatment must use airflow machines during their sleep because taking Modafinil without CPAP severely increases the chance of cardiovascular side effects. Other side effects of Modafinil may cause nausea, dizziness, headache, anxiety, chest pain, and insomnia.
Acetazolamide Acetazolamide is classified as a respiratory stimulant that is commonly used by mountain climbers to avoid altitude sickness. This medicine has shown success in decreasing the number of apnea episodes and frequency of daytime sleepiness. However, patients may develop tolerance of Acetazolamide when it is used for an extended period. Under such circumstances, the medication may no longer work as well unless the dosage is readjusted.
Also, patients with diabetes should be aware that Acetazolamide is a diuretic.